Using the Case Study Provided at the End of the Module Identify and Explain the Client’s Issues and Devise a Course of Treatment for Him, Taking Into Account Any Ethical Issues.

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  • Topic: Believe... There's Magic in the Stars
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Presenting Issue and Background
Mr X is a 45 year old man who has worked at the same Estate Agency for 18 years. He has presented to me with the issue that he would like to apply for the manager’s position at his branch but his lack of confidence is holding him back. Mr X has stood in for the current manager on many occasions so he knows that he is capable of doing the job but has reservations as he doesn’t want to cause any upset amongst the other staff or management if he is not successful. Further discussion with Mr X revealed that one of the reasons he would like the job as manager is so that his mother would be proud of him and show him a little more respect. She is currently living in a home and he visits her regularly every Friday night although he says she tends to pick on him. Mr X isn’t clear how or why his mother picks on him, just that she does. It also transpires that Mr X’s colleagues tend to go out for drink after work on a Friday night on a fairly regular basis but because of his commitment to visiting his mother he feels he cannot join them. He believes that they find him boring and unsociable because of this. Mr X has considered changing the day he visits his mother on the odd occasion so he can join his colleagues but feels his mother wouldn’t understand this and would pick on him even more than usual. He has also thought about asking his colleagues to join him on a different night of the week for drinks but believes they would say no and fears their rejection. Mr X has a girlfriend he describes as a ‘sort of girlfriend.’ He says he would like to propose to her but, again, fears rejection. He also doesn’t feel as if he has much to offer her which is another reason the manager’s job is an attractive prospect. Mr X seems to be a man who is very aware of other people’s feelings and worries about how he comes across and what others think of him. I have assessed him as visual in modality. Assessment

The first thing that jumps out about Mr X and his presenting issue is that he obviously has a serious lack of confidence. He doesn’t believe in himself and his own abilities, either in his personal life and personal relationships, his relationships with his co-workers, or in his career. However, the first thing I would take into consideration in this case is something not actually mentioned in the initial information provided, but it’s something that would give me concern and something I feel would need to be addressed before any treatment was offered. Is Mr X suffering from depression? As a therapist it would be unethical for me to treat a patient who has not been diagnosed as being depressed but whom I feel may be suffering from depression. In this instance I would suggest to Mr X as politely and as tactfully as possible that he seek help or advice from his GP before seeking any further assistance from me. This is obviously assuming that as an ethical and professional therapist I have taken a medical history and have asked for information regarding any medication Mr X is taking and also any additional or alternative treatment he is receiving and have taken it all into account. If Mr X has already had a diagnosis of depression then I would, again, have to consider my options before agreeing to treat him. As a novice therapist I am not allowed to treat a client who is suffering from depression and I would probably refer Mr X to a more experienced associate, explaining that he would receive a more fulfilling and successful treatment from Ms Y than from me. As there is no mention of depression or anti-depressants in the initial information provided I am going to assume Mr X is not suffering from depression, either diagnosed or undiagnosed and I am able, ethically and to the best of my ability, to treat him. The presenting problem seems to be a lack of confidence. Mr X wants the confidence to apply for the manager’s position. He also wants the confidence to be more interactive with his colleagues...
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